Fractures

Question 1

What are the prinicples of management for fractures?

Answer 1

• ABCs, rule out other fractures
• Reduce fracture
  
  • Closed - apply traction in long axis and reverse mechanism (may require sedation/relaxants)
  • Open - surgical
• Monitor pre/post NV status
• Maintain reduction
  
  • External fixation - splints/casts/traction
  • Internal fixation - pins/screws/plates/rods

Question 2

What are the indications for open (surgical) reduction of a fracture?

Answer 2

Failure of closed reduction

• N - non-union
• O - open fracture
• C - compromise of NV structures
• A - articular fracture (intra)
• S - Salter-Harris 3-5
• T - polytrauma